BILL ANALYSIS Ó AB 1288 Page 1 Date of Hearing: May 15, 2013 ASSEMBLY COMMITTEE ON APPROPRIATIONS Mike Gatto, Chair AB 1288 (V. Manuel Pérez) - As Amended: April 11, 2013 Policy Committee: Business, Professions and Consumer Protection Vote: 12-1 Urgency: No State Mandated Local Program: No Reimbursable: No SUMMARY This bill requires the Medical Board of California (MBC) to develop a priority review process for applicants for a physician's and surgeon's certificate who demonstrate their intent to practice in a medically underserved area (MUA) or serve a medically underserved population (MUP), as specified. FISCAL EFFECT Costs to MBC should be minor and absorbable to develop the required review process. This bill does not require any outreach or other activities by MBC to put an applicant on the priority list. Rather, this bill specifies acceptable documentation for an applicant to submit to demonstrate intent, including but not limited to, a letter from an employer indicating the applicant has accepted employment and stating the start date. COMMENTS 1)Rationale . This bill aims to increase the number of newly certified physicians and surgeons practicing in MUAs or serving a MUP by requiring MBC to develop a priority review process for applicants for a physician's and surgeon's certificate for licensure that demonstrate an intent to do so. This bill is sponsored by the California Medical Association. According to the author, there is not currently a backlog of applications but in the past backlogs did occur due to budget actions and an influx of applications. 2)Licensing application process . MBC's initial review process AB 1288 Page 2 for license applications must be completed within 60 business days. According to MBC's website, the entire process can be lengthy and individuals are encouraged to start the application process at least six to nine months before they intend to practice. Once a file is reviewed, the applicant is notified in writing of the application status and given an itemized list of documents needed to complete the file. The missing documents requested by MBC are reviewed in order of receipt. Only about 10% of applications are found to be complete at the initial review. The additional documents required for a physician and surgeon certificate often must be sent directly from hospitals or other entities, which may help explain the high level of incompletion and the long delays. If a file is complete upon initial review, the license will be issued within seven to ten days. 3)Currently, MBC finds that it is completing an initial review of applications within 45 calendar days, well under the mandated 60 business days. MBC does not request any information regarding where an applicant plans to work once licensed. During fiscal year 2011-12, MBC received 6,623 applications and granted 5,351 licenses. Although MBC is not currently experiencing a licensing backlog, this bill will still require MBC to establish a priority review process in order to streamline the application process for those physician and surgeon applicants who can demonstrate their commitment in writing to working in MUAs or serving MUPs. 4)Medically underserved areas and populations . MUAs are defined as healthcare shortage areas as specified in federal regulations or an area of the state where unmet needs for physicians exist as determined by the Office of Statewide Health Planning and Development (OSHPD). The Commission reviews and designates priority geographic areas in California to address the unequal distribution of healthcare services where unmet medical needs persist. Among the areas that are designated as MUAs are Modoc County and portions of Trinity, Inyo, Riverside, Shasta, Del Note, Tulare and Kings Counties. MUPs are areas where persons are served by the Medi-Cal or Healthy Families programs, or where there is an uninsured population. Examples of areas that are designated by OSHPD as MUPs are Mendocino County and portions of Lassen, Tulare, Plumas and Riverside counties. Analysis Prepared by : Debra Roth / APPR. / (916) 319-2081 AB 1288 Page 3